AMA CPT® Assistant - 2013 Issue 9 (September)
Molecular Pathology Update (September 2013)
September 2013 pages 3-12 Molecular Pathology Update The American Medical Association (AMA) established the molecular pathology codes in 2012. To ensure maximum accuracy and technological input, the Current Procedural Terminology (CPT) has incorporated increased transparency by expediting the publication of new or modified Tier 2 analyte molecular pathology services as well as implementing other changes to allow for better utilization of the CPT code set. Tier 2 services are of lower volume but they are medically useful and commonly performed tests. Coupled with the Tier 1 codes, 90% to 95% of current molecular pathology procedures are captured by these...
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Article Overview
This article explains September 2013 CPT molecular pathology updates and the surrounding reporting framework. It covers the AMA/CPT publication workflow, the structure of molecular pathology Tier 1 and Tier 2 updates, added definitions, revised guidance for unlisted molecular pathology reporting, and frequently asked questions that address how the 2013 molecular pathology code set is organized. It is intended for coders, laboratorians, and billing staff who need to understand the scope of the 2013 molecular pathology changes and where updated analytes fit within CPT.
Why This Topic Matters
Molecular pathology coding changes can affect how laboratory services are reported, tracked, and implemented by payers. This article helps readers understand the 2013 update cycle and locate the relevant CPT framework before applying the premium guidance.
Article Sections
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September 2013 pages 3-12
Introductory material for the issue and article placement within the publication.
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Molecular Pathology Update
Background on the CPT molecular pathology code structure and the AMA’s approach to publishing and updating these services.
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New Information on Molecular Pathology on the AMA Web site
How molecular pathology and related assay codes are released, posted, and implemented through the AMA website and CPT Editorial Panel process.
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Print Publication Date, Publication to AMA Web site, and Implementation Date
Discussion of timing differences between publication, website release, and effective dates for molecular pathology codes.
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CPT Changes for 2013
General overview of the molecular pathology code families, naming conventions, analytical scope, and coding framework used in CPT 2013.
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New Guidelines
Revisions to molecular pathology reporting guidance, including treatment of codes outside the specified Tier 1 and Tier 2 groupings.
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New Definitions
Definitions added for selected molecular pathology terminology used in CPT reporting.
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Tier 1 Molecular Pathology Procedures
Summary of newly added Tier 1 molecular pathology procedures and related parenthetical notes for the 2013 code set.
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Tier 2 Molecular Pathology Procedures
Discussion of editorial revisions and added analytes within the Tier 2 molecular pathology code family for 2013.
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Frequently Asked Questions
Question-and-answer guidance addressing broader reporting scenarios, unlisted service use, laboratory repetition, and related molecular pathology coding issues.
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Category I Molecular Pathology Tier 2 Codes
A reference-style listing of the Category I Tier 2 molecular pathology code family and associated analytes published for 2013.
What You Will Learn
- How the 2013 molecular pathology update fits into the CPT publication and implementation cycle
- How Tier 1 and Tier 2 molecular pathology services are organized in CPT
- What types of editorial revisions were made to molecular pathology guidance for 2013
- How unlisted molecular pathology reporting is addressed in the article
- What kinds of questions the article answers about molecular pathology code reporting
- How the article frames the relationship between analyte-specific reporting and the CPT code set
Who Should Read This
- Medical coders
- Pathology and molecular laboratory staff
- Revenue cycle and billing personnel
- Compliance staff
- Coding educators and auditors
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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